The increased diabetes risk is at least somewhat expected from all sweeteners, regardless of origin or caloric load.
As an intuition, the fact that you taste something as sweet indicates that your brain has received a strong signal, and your hormonal responses are mostly regulated by signals sent from the brain to specialized organs.
In practice, the data strongly supports any well-studied sweetener increasing the risk of diabetes and also increasing hunger sufficiently to at least partially mitigate any caloric benefits.
The rest of the data I've seen on artificial sweeteners is a dogmatic quagmire with respect to cancers, neural issues, and whatnot, so I wouldn't personally want to draw many conclusions based on it, especially given the conflicts of interest in how most of it was generated. However, on both sides of the debate I think it's worth honestly considering at least those two dangers, especially considering the aggressive marketing of "natural" sweeteners like stevia and monk fruit with a strong implication that being natural means it's safe, and especially with detractors on the other side pointing to a bunch of shitty science over the years as evidence that sugar substitutes are probably safe.
I believe there have been some studies that show that artificial sweeteners affect your insulin response to real sugar, but I think it's far from settled science.
Indeed. I think it helps to unpack the various claims being studied:
1) Carcinogenicity. Do certain sweeteners cause harmful mutations and increase cancer risk? This is one of the oldest and most frequent allegations, especially against saccharin and aspartame. Mostly inconclusive, though both sweeteners have been exonerated at least as often as they've been accused.
2) Insulin triggering. Artificial sweeteners may not bear the caloric load of sugars and starches -- but do they trigger the release of insulin, just the same? Again, the jury is still out, but certain sweeteners (aspartame, sucralose, and possibly saccharin) are looking suspect.
3) Caloric load. Some sweeteners and putatively indigestible molecules (sugar alcohols, "resistant starches," etc.) may contain more effective calories than in vitro studies predict them to contain. This is because the chemicals aren't digested in the traditional sense, but are fermented and absorbed in the gut. Caloric bioavailability is often different from nominal calorie count. (Indeed, this is the entire principle behind the supposed benefits of resistant sweeteners and starches; those benefits may have been overstated or misunderstood).
4) Disruption or adverse selection of gut microbiota. As detailed in this study. While not all sweeteners have been implicated here, this field of study is only just kicking into high gear. It seems reasonable to suspect that molecules fermented by / consumed by gut bacteria could have some effect on flora composition. Many sweeteners fit that criterion.
5) Other toxicities. Liver or kidney toxicity, neurotoxicity, endocrine disruption, etc. As with carcinogenicity, the jury is still out. Unlikely for some sweeteners that are not metabolized via these pathways. Possible for others. Most sweeteners (all?) on the market right now are generally recognized as safe in this respect, despite popular beliefs to the contrary. Notable exceptions exist for those with rare metabolic or genetic disorders, such as phenylketonuria (aspartame contains phenylalanine).
6) Side effects. Some sweeteners, particularly those in the sugar alcohol family (and sorbitol especially), can cause laxative effects and other GI-related issues. Individual tolerance can vary. Breaking this category out from #4 because the action here can be purely mechanical (i.e., increasing intestinal water absorption).
I'm not a doctor or medical researcher myself. Just an interested nerd. But I have been following this area for awhile. I welcome any corrections, comments, or additions from people more knowledgeable than I am. I assume there are many such people on HN. :)
I was big on artificial sweeteners (I refuse to eat any sugar), mainly erythritol and monkfruit, but some science(1) says that just their taste profile can trick your body into thinking it's consuming a real sugar with the associated glucose/insulin response and this could be one reason as to why non-nutritive sweeteners can throw your blood and insulin response profiles out of whack, which may be a reason as to why individuals who consume artificial sweeteners suffer the same maladies as those who consume high levels of sugar.
If the science on this issue becomes conclusively affirmative, then it's sort of the nail in the coffin for artificial sweeteners, because it doesn't matter what the compositional makeup of the sweetener is, it's our own bodies own responses to the taste/smell that are giving us the ill effects.
I would definitely like to be dissuaded as to believing this is not the case, though, as it's caused my to ignore my sweet tooth for far too long! :)
For those who are interested in and/or consume artificial sweeteners, I think this link is definitely worth a read:
This article is rife with statements that appeal to "common knowledge" then back it up with "some doctors say" followed by implications of corruption because they took money from corporations.
I know there is concern over artificial sweeteners but I haven't seen any convincing evidence of the danger. Considering that artificial sweeteners have been some of the most studied chemicals out there, I'd expect to see some solid evidence. Most studies, including the one cited in the article, show a correlation between artificial sweeteners and diabetes but the criticism of those links is usually that the people who use artificial sweeteners are people who already have habits that would cause diabetes that they are trying to curb with artificial sweeteners.
I'm not sure artificial sweeteners are good for anything.
A 2019 meta analysis published in the British Medical Journal said, "Most health outcomes did not seem to have differences between the NSS (Non-sugar sweeteners) exposed and unexposed groups." - https://www.bmj.com/content/364/bmj.k4718
My guess is that things tasting sweet is part of the problem. For example:
"Ingestion of these artificial sweeteners (AS) results in the release of insulin from pancreas which is mistaken for glucose (due to their sweet taste). This increases the levels of insulin in blood eventually leading to decreased receptor activity due to insulin resistance." - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7014832/
Apparently artificial sweeteners can stimulate a large insulin response through the sweet taste receptors even though they don't increase the blood sugar - this over time can cause weight gain and reduce the effectiveness of insulin leading to Type 2 diabetes.
I say apparently because its been passed on to me in conversation with friends who medical staff. However that was a number of years ago and I haven't done the research myself to confirm; so as with every thing on the internet, take it with a grain of salt.
i read somewhere that artificial sweeteners cause the body to make you eat more because sweet taste signals sugar incoming and then there is no sugar so the body craves more to make up for that. not sure if thats true.
my main concern is that many artificial sweeteners are suspected to cause cancer
From the linked study, "These findings of positive associations between artificial sweetener intakes and increased T2D risk strengthen the evidence that these additives may not be safe sugar alternatives."
This is news to me. I was under the impression that: 1) artificial sweeteners were a safe substitute for sugar for people with diabetes and 2) diabetes came from excess sugar consumption which wasn't a problem with artificial sweeteners.
Yeah, it appears that stevia would likely have similar effects, as it has been suggested that tasting sweetness causes an spike in insulin without a corresponding bump in blood glucose levels, leading to an excess of insulin[1].
What causes the difference in effect between glucose and artificial sweeteners appears to be the taste of sweetness without the carbohydrates that would go along with natural sources of sweet taste.
Your impressions 1 and 2 can both be correct, and there still be an association between artificial sweeteners and type 2 diabetes.
It has been shown for decades that this association exists, it's establishing cause, and causal direction that's hard. Does consuming artificial sweeteners cause diabetes? Or does having diabetes cause the consuming of artificial sweeteners?
IIRC artificial sweeteners do not affect blood sugar directly, but they can still cause an insulin response, lowering blood sugar and making one hungry.
Studies lately are showing that artificial sweeteners are just as bad if not worse for you than sugar.
Apparently aside from the nasty chemicals, they still trigger an insulin response which makes your blood glucose crash and makes you crave sweet, fatty foods.
There is all kinds of solid research on the detrimental effects of artificial sweeteners.
One area that comes to mind where there is _a lot_ of redundant evidence backing up effects is on the microbiome.
Another is glucose uptake pathways and insulin resistance.
These things aren't myths, prior to this article I'd never heard anyone suggest that possibility. The amount of research, approaching the problem from numerous angles, arriving at a similar conclusion, is hard to deny.
Right, but for the purposes here, it's probably enough to say that several artificial sweeteners are unexpectedly bioactive. As such they perhaps are doing things that are undesirable.
Recent and past research has linked sweeteners to obesity, diabetes, and even heart disease. Some studies show it results in larger weight gain than consuming sugar.
In addition to those, substances like sodium cyclamate and aspartame have been linked to cancer after being considered 'safe' for decades. Who knows when they'll declare the same for neotame and other new sweeteners? If only xilitol made from bark was cheaper...
I think the conclusion is that there is no magic formula for eating sweets without the consequences, avoiding refined sugar, high-fructose and similar stuff is the way to keep healthy and out of trouble.
ps: stevia is probably safe, but I find it has too much of a bitter aftertaste.
I'm interested in that last statement regarding aspartame. It seems you find extremely polarized opinions on artificial sweeteners. I've often read that, regardless of the health impact (or lack thereof), artificial sweeteners are more-or-less "tricking" your body into thinking it has calories incoming, when in fact, it doesn't. Your body, feeling jipped, tries to compensate by craving more calories. But, again, this is hearsay.
As an intuition, the fact that you taste something as sweet indicates that your brain has received a strong signal, and your hormonal responses are mostly regulated by signals sent from the brain to specialized organs.
In practice, the data strongly supports any well-studied sweetener increasing the risk of diabetes and also increasing hunger sufficiently to at least partially mitigate any caloric benefits.
The rest of the data I've seen on artificial sweeteners is a dogmatic quagmire with respect to cancers, neural issues, and whatnot, so I wouldn't personally want to draw many conclusions based on it, especially given the conflicts of interest in how most of it was generated. However, on both sides of the debate I think it's worth honestly considering at least those two dangers, especially considering the aggressive marketing of "natural" sweeteners like stevia and monk fruit with a strong implication that being natural means it's safe, and especially with detractors on the other side pointing to a bunch of shitty science over the years as evidence that sugar substitutes are probably safe.
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